decisionhealth Newsletters, Part B News - 2013 Issue 8 (August)
Watch for higher Medicaid E/M, vaccine payments as states start doling them out
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Article Overview
This article covers the early implementation of a federal Medicaid primary care payment initiative and how states are beginning to distribute the higher payments. It discusses CMS guidance affecting provider eligibility, state plan amendment progress, managed care and fee-for-service timing, and related administrative issues for physicians and non-physician practitioners. It is relevant to coders, billing staff, practice administrators, and providers who follow Medicaid reimbursement policy.
Why This Topic Matters
It helps readers track when enhanced Medicaid primary care reimbursement may begin in their state and understand the administrative guidance shaping eligibility and claims processing.
Article Sections
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Advance preview -- Physician payments
Overview of the rollout of increased Medicaid primary care payments and the timing of state implementation. Mentions CMS state plan amendment activity and early state payment updates.
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Allergists eligible for higher payments
Discussion of CMS guidance on practitioner eligibility, with attention to subspecialty recognition and related federal clarification.
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NPPs must be under doc supervision
Summary of CMS guidance addressing non-physician practitioner supervision and how states are handling attestation or supervision requirements.
What You Will Learn
- How states are beginning to implement enhanced Medicaid primary care payments
- What CMS guidance addresses provider eligibility for the payment increase
- How state administrative processes affect payment timing and claims adjustments
- What types of practitioner supervision issues are discussed in the rollout guidance
Who Should Read This
- Physicians
- Practice administrators
- Medical billers
- Medical coders
- Medicaid billing staff
- Compliance staff
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